Inspection on 14/02/07 for Redholme

This inspection was carried out on 14th February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Redholme 24/01/06

Redholme 12/07/05

Redholme 14/10/04

Redholme 14/05/04

Redholme 12/02/04

Similar services:

St Vincents

The Cotswold Home

Winton House

Newbeech House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Redholme Forest Road Whitehill Bordon GU35 9BA Lead Inspector Val Sevier Key Unannounced Inspection 14th February 2007 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Redholme DS0000012156.V324457.R02.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Redholme DS0000012156.V324457.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Redholme Address Forest Road Whitehill Bordon GU35 9BA Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01420 472 467 Mr Hurryprasad Matadeen Mrs Ermelinda Matadeen Mr Hurryprasad Matadeen Care Home 5 Category(ies) of Old age, not falling within any other category registration, with number (5) of places Redholme DS0000012156.V324457.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th January 2006 Brief Description of the Service: Redholme is a detached house situated in a quiet residential area, a short walk from the village of Whitehill. The owners live on the premises and personally provide the care needed to meet the needs of the service users; care/domestic staff are not employed. The home provides a residential service to up to five older people who are actively encouraged to maintain their independence. The fees at the home are between £319 and £327. Redholme DS0000012156.V324457.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The purpose of the inspection was to assess how well the home is doing in meeting the key National Minimum Standards and Regulations. The owners Mr and Mrs Matadeen live in the house their accommodation is on the top floor, they also provide all care. The findings of this report are based on several different sources of evidence. These included: an unannounced visit to the home, which was carried out on the 14th February 2007, during which the inspector was able to have discussions with owners and have interaction with the residents at the home. During the visit to the home a tour of the premises was carried out which included bedrooms. Care records were sampled and in addition to speaking with the owners and residents, their day-to-day interaction was observed. Some standards have been judged based solely on the comments from the residents. All regulatory activity since the last inspection was reviewed and taken into account including notifications sent to the Commission for Social Care Inspection. The owners Mr and Mrs Matadeen assisted throughout the inspection. What the service does well: What has improved since the last inspection? Mr Matadeen has put a risk assessment to cover all the chemicals used at the home as required from the last visit. Redholme DS0000012156.V324457.R02.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Redholme DS0000012156.V324457.R02.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Redholme DS0000012156.V324457.R02.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 2 & 3 (6 is not applicable) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are contracts for each individual residents describing the terms and conditions of the service. The home’s admission procedures included assessments of the needs of potential residents before they moved into the home to ensure that the home could provide the care and support that individuals required. EVIDENCE: The home had written policies and procedures concerned with the admission of new residents to the home and these referred to the importance of ascertaining the help required by potential residents before they moved into the home. There have been no new admissions to the home since the last inspection with the last resident moving to the home in 2005. The inspector sampled the records of the residents at the home, three of whom have been at the home before pre admission assessments were needed. For those who were admitted Redholme DS0000012156.V324457.R02.S.doc Version 5.2 Page 9 after 2002 when homes were required to carry out pre admission assessments, it was noted that there were documents that had been completed. There were terms and conditions and contracts between the home and the residents stating the service to be given. Social services have been involved in the past however the residents that are funded through social services have not been reviewed recently. Redholme DS0000012156.V324457.R02.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 & 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is an understanding of the support needs of individuals however there is no clear care planning to support this with particular reference to the needs of individual mental well being. The residents are not protected with a thorough assessment of risk. The systems of administration of medication potentially pace residents at risk. EVIDENCE: The inspector viewed all five care plans. The plans gave information about the needs of the individual and whether support was needed, most of the individuals were independent in their daily lives although as they became older it was noted that prompts were now being given. Care plans seen covered needs in washing dressing, using the bathroom, meals, mobility and leisure. On the day of the inspection the residents were all being supported in having a shower, which the residents spoken to said that the shower was quick and they had had help. Redholme DS0000012156.V324457.R02.S.doc Version 5.2 Page 11 The owner commented that one resident had become frail recently and had a fall when out shopping. Whilst this had been noted in the daily comments there were no risk assessments in place. It was noted that there were no risk assessments for any of the residents. The inspector found information on all care plans that residents had either in the past or were currently receiving medication and support for their mental health, one resident is visited fortnightly by a community psychiatric nurse. For others there was a mention of a history of poor mental well being, however there were no care plans to reflect these needs or the support needed or given. This was discussed at the time with Mr Matadeen. There was evidence that physical health needs such as dentist; chiropody and opticians were being met with either family support or Mr Matadeen taking the individual to appointments. However where one individual was noted to have difficulty breathing and was prescribed inhalers and a Nebuliser there was no care plan to reflect this need or the support that they needed. It was noted that the care plans are reviewed regularly, there are notes about the lives of the residents however these reflect occurrences such as trips out and appointments not the daily life of the individual and are therefore not competed daily. The inspector reviewed the medication storage and administration. The home uses a blister pack system and records medication given on the Medication and Recording system (MAR sheets). The home has a medication policy, and this was seen to be supported by other guidance such as the Royal Pharmaceutical Guidelines. Since the inspection Mr Matadeen has confirmed and given evidence that this guidance is available at the home. It was noted that some of the residents had been prescribed creams and lotions, however there was no record that they had been given; Mr Matadeen stated that the residents looked after these themselves. It was further noted that the individual who is prescribed inhalers, ‘self administers’ them, there was no evidence that an assessment or agreement for self-administration. It was noted that this individual also needed prompting with using the Nebuliser and could become argumentative about it. The Comments from residents about the help that they received included the following: “They help me with things I need like taking my pills and having a shower”. “I am very independent really but they help me with bathing”. “The people look after me very well”. The inspector was able to observe the interaction with residents and that privacy and dignity was promoted. Redholme DS0000012156.V324457.R02.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13 14 & 15 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home ensures that residents lead the lifestyle they choose, and residents enjoy the food. EVIDENCE: Mr Matadeen said that there used to be singers who visited the home but residents did not enjoy this activity. Holy Communion was held on the day of the inspection, and some residents attend a church function once a month. Some residents go out independently for recreation, others choose not to. Although as they become frail Mr Matadeen said there were now concerns, as one resident had fallen recently whilst out. Residents watch television or listen to radio, and none of them wished for any further activities to happen. Residents said they could decide when to go to bed. The residents said that they go out in better weather with Mr and Mrs Matadeen in the bus (a large people carrier). Redholme DS0000012156.V324457.R02.S.doc Version 5.2 Page 13 Residents are able to bring personal possessions into the home when they move in, or at a later date. Residents manage their own money if they are able, or family manage. The inspector was able to speak with the residents about their meals and they commented that the meals were nice. All of the residents chose to eat their meals in their rooms, one said that this suited them as they ate slowly and didn’t feel under pressure to hurry. On the day of the inspection there was mince or chicken fresh vegetable sand rice pudding. The residents said that tea was usually a sandwich, which was ‘okay’. The home keeps a record of the meals served and what individuals have had. Redholme DS0000012156.V324457.R02.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Mr and Mrs Matadeen have knowledge and understanding of Adult Protection issues which protects residents from abuse. Residents can be confident that their views are known to staff and are fully taken into account. EVIDENCE: The home has a complaints procedure although this was not seen on display. The residents said that they felt they could tell Mr and Mrs Matadeen if they had any worries. No complaints have been received verbally or in writing by either the home or the commission since the last inspection. The home had a copy of the Hampshire Protection of Vulnerable Adults Policy dated 2002; Mr Matadeen was advised that there is a more recent version available. Mr and Mrs Matadeen were seen to have been on adult protection training since the last inspection. Redholme DS0000012156.V324457.R02.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s accommodation was furnished and equipped satisfactorily for residents needs. EVIDENCE: The resident’s accommodation is situated on the ground floor of the house. All have their own room and the sizes are published in the home’s service users guide. The resident said that they had been able to bring some of their own belongings with them. One resident had a radio and a television in their room whilst another chose to have a quiet room, although their room was next to the communal lounge and the volume of the television occasionally disturbs them. There is a communal dinning room although residents aid they preferred to have their meals in their room. Mr and Mrs Matadeen do the laundry and cleaning. The appeared homely and was clean and there were no malodours. Redholme DS0000012156.V324457.R02.S.doc Version 5.2 Page 16 Four of the five rooms were seen to have a nurse call with a pull cord attached. Mr Matadeen said that the resident in the fifth room knew how to use the button on the nurse call system. The bedrooms were naturally ventilated and heated by radiators that were covered with guards to safeguard residents from the risk of burns. One resident said that the room could be drafty as the windows didn’t seem to fit properly on one side otherwise all were satisfied with their rooms. Redholme DS0000012156.V324457.R02.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 27, 28, 30. (Standard 29 does not apply as Mr & Mrs Matadeen do not employ any staff.) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care given by Mr & Mrs Matadeen appears to be sufficient to meet the needs of the residents. There was evidence to confirm that the residents are protected through Mr and Mrs Matadeen receiving sufficient and appropriate training. EVIDENCE: Mr and Mrs Matadeen do not employ any staff and care for the residents themselves. They do not often have a break. There were certificates available to see for Mrs Matadeen however Mr Matadeen’s certificates for course attendance were not available at the time; Mr Matadeen has since forwarded the certificates to the CSCI. Redholme DS0000012156.V324457.R02.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35 & 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home appears to be generally well managed with residents able to have a say in the homes running. The home is maintained and health and safety is promoted however there is a lack of risk assessment and concerns over medication, which may place residents at risk. EVIDENCE: Mr Matadeen maintains the records and policies and procedures for the home, he was advised that an improved filing system might help in tracking the information that he needs. Redholme DS0000012156.V324457.R02.S.doc Version 5.2 Page 19 Mr and Mrs Matadeen need to ensure that care plans are improved with additional information on how mental health needs are supported; risk assessments for self medicating and other risk assessment for daily life activities. It was noted that questionnaires about the service offered at the home had been completed by residents in November and December 2006 however these have not been evaluated. Mr Matadeen said that he and is wife do not have responsibility for any residents monies this is looked after by the residents, their families or social services. The fire records were seen and it was noted that the last fire drill was in August 2006 another is due February 2007. A provider company tested the fire equipment in January 2007 and a certificate was seen. It was noted that the fire safety system and equipment at the home is tested weekly and a record of this is kept. A basic COSHH risk assessment has been implemented since the last inspection, which is generic for all products, used at the home. Other certificates of maintenance of equipment were seen. Redholme DS0000012156.V324457.R02.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 N/A 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 2 Redholme DS0000012156.V324457.R02.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 Sch 3 Requirement Timescale for action 14/05/07 2 OP9 13 (2) 3 OP38 13(4) There must be a written record of all of the support needs for all individuals at the home this includes mental health and physical health such as breathing difficulties to ensure that all support has been identified. An assessment must be carried 14/05/07 out for individuals that wish to self-administer medication and a record must be kept. Risk assessments must take 14/05/07 place for individuals in all areas of their daily lives and where a risk is identified a record must be kept of how this has been lessened. Redholme DS0000012156.V324457.R02.S.doc Version 5.2 Page 22 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Redholme DS0000012156.V324457.R02.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Redholme DS0000012156.V324457.R02.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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